Important Medicare Prescription Drug Plan (Medicare Part D) Update
If you are a Medicare beneficiary, you have choices in your Medicare Prescription Drug coverage. You may choose from different Medicare prescription drug coverage options. One option is to purchase coverage through a Medicare Prescription Plan (PDP). Another option is to get your prescription drug coverage through a Medicare Advantage Plan that offers prescription drug coverage. This is the biggest change to Medicare in 40 years!!!
All approved participating companies are allowed to solicit their plan designs, costs and enrollment information beginning October 1st.
Note: Enrollment applications cannot be accepted or transmitted to the Centers for Medicare & Medicaid Services (CMS) before the open enrollment start date of November 15th.
You may enroll between November 15th and December 31.
Take time to review marketing materials that are presented to you from approved plan participants. There are slight variations between approved plan designs. You may realize additional savings in a program that offers mail order prescription fulfillment.
What assistance is available to you in comparing approved plans?
v Beginning mid to late October the Center for Medicare & Medicaid Service (CMS) office will begin sending information to Medicare beneficiaries comparing available Part D coverage via mail with the Medicare & You handbook
v Call 1-800-MEDICARE for assistance (TTY/TDD users should call
(877)486-2048)
v A Plan Comparison Web Tool and Personal Plan finder is available on www.Medicare.gov.
v Social Security Administration: (800) 772-1213 (TTY/TDD users call (800)325-0778)
v Call our office for assistance at (800) 553-6676
v IMPORTANT: If you or your spouse has employer group coverage, you should talk to your employer to find out how your benefits will be affected if you join a Medicare PDP. Get this information before you decide to enroll in any plan.
What is a prescription drug formulary? A Prescription Drug Plan may use a prescription formulary. A formulary is a preferred list of drugs selected to meet patient needs. The plan may periodically make changes to the formulary. If the formulary changes, all affected enrollees will be notified in writing before the change is made.
All Medicare Prescription Drug Plans have agreed to stay in the program for a full year at a time. Each year, the plans decide whether to continue for another year. If a plan decides not to continue, it must send you a letter at least 90 days before your coverage will end.
Below are the Centers for Medicare and Medicaid Services (CMS) Medicare deductibles and co-payments for 2010. These become effective January 1, 2010:
|
v PART A (Hospitalization)
o $1,100 Deductible per Benefit Period
o $275 Co-payment per Day from the 61st to the 90th Day
o $550 Co-payment per Day after day 90 (Lifetime Reserve Days)
o All costs for each day beyond 150 days.
v PART A (Skilled Nursing Facility)
o $137.50 Co-payment per Day from the 21st to the 100th Day
v PART B (Medical)
o $155 Deductible per Calendar Year (Note: you pay 20% of the Medicare-approved amount for services after you meet the $155 deductible)
The 2010 Part B monthly premium rates to be paid by beneficiaries who file an individual tax return (including those who are single, head of household, qualifying widow(er) with dependent child, or married filing separately who lived apart from their spouse for the entire taxable year), or joint tax return are:
| File Individual Tax Return |
File Joint Tax Return |
You Pay |
| $85,000 or below |
$170,000 or below |
$110.50* |
| $85,001-$107,000 |
$170,001-$214,000 |
$154.70* |
| $107,001-$160,000 |
$214,001-$320,000 |
$221.00* |
| $160,001-$213,000 |
$320,001-$426,000 |
$287.30* |
| $214,000 or greater |
Above $426,000 |
$353.60* |
*If you pay a late-enrollment penalty, this amount is higher.
